ABERDEEN PROVING GROUND, Md. – Longer days, sunshine and spring flowers are a welcome sight for most people, but what may not be as welcome is the beginning of tick season. May is Lyme Disease Awareness Month and active-duty servicemembers training outdoors as well as other Department of Defense personnel or beneficiaries working outside or simply enjoying the weather should be aware of ticks and the threats they can pose.
In addition to the longer days that come with spring and summer, the Environmental Protection Agency says there is evidence that climate change has also contributed to the expanded range of ticks, increasing the potential risk of Lyme disease where the ticks were previously unable to survive. The life cycle and prevalence of deer ticks are strongly influenced by temperature. The incidence of Lyme disease in the United States has nearly doubled since 1991, from 3.74 reported cases per 100,000 people to 7.21 reported cases per 100,000 people in 2018.
Lyme Disease is the most common vector-borne disease in the U.S., with more than 300,000 new cases every year, according to the Centers for Disease Control and Prevention. Most of those new cases arise during the spring and summer months, when tiny nymphal blacklegged ticks (also called deer ticks) are out biting people. It’s important for anyone going outside into tick habitat (brush, woods, tall grass, even yards and lawns) to do a thorough tick check of themselves and any children during tick season.
“Ticks can be very tiny, smaller than a sesame seed, and while the bacteria that cause Lyme disease usually take about 48 hours of tick attachment to transmit from the tick to a person, other pathogens can be transmitted much more quickly,” said Robyn Nadolny, Army Public Health Center biologist and chief of the Vector-Borne Disease Branch.
Nadolny says it’s always safest to remove a biting tick as quickly as possible. Instructions for how to do this can be found in the APHC resource library.
If you do remove an attached tick this season, there is a resource that has been around for more than 20 years through the APHC Vector-Borne Disease Branch offering free identification and analysis of ticks that have been removed from human patients. The Military Tick Identification/Infection Confirmation Kit, or MilTICK, program, allows active-duty servicemembers and DOD beneficiaries, including contractors and DOD civilians, to submit their ticks for identification and testing without needing to visit a clinic or even order a test kit.
The purpose of this program is to expediently provide tick species identification, engorgement level (a relative indicator of attachment duration which correlates with infection potential.), and analysis for the pathogens that cause the following human illnesses: Lyme disease, Rocky Mountain spotted fever and related spotted fevers, ehrlichiosis, anaplasmosis, babesiosis, and Powassan virus, said Nadolny.
“Since different tick species transmit different pathogens or groups of pathogens, and since most tick-borne illnesses often exhibit virtually identical early symptoms, tick species, engorgement, and infection status may be useful to the physician in evaluating and monitoring the patient’s health, and in making diagnostic and treatment decisions,” said Nadolny.
APHC’s MilTICK program expanded access to DOD beneficiaries in 2020, but actually saw a 60 percent drop in submissions compared to the previous year. The MilTICK program usually receives about 2,500 to 3,000 ticks per year, but this dropped to 977 in 2020, said Nadolny. She believes the drop may have been due in large part to decreased military training and operations in 2020 due to the COVID-19 pandemic.
“Usually more than 50 percent of submissions are occupational exposure, but in 2020 only 25 percent of submissions were from on-the-job exposures to ticks,” said Nadolny. “Also, we normally get about 1,000 ticks annually sent in from Fort Knox, where the Army trains about 3,000 ROTC cadets every summer, but received none in 2020.”
Nadolny said nearly 25 percent of her 2020 tick submissions were from children. The numbers have started to go up, but they still are not back to pre-pandemic levels.
“We saw an 88 percent increase from 2020 and back to the usual demographics of participants, but we’re still down 30 percent from our last regular year in 2019,” said Nadolny.
Nadolny hopes to see participation in the MilTICK program return to or exceed pre-pandemic levels, and to get the word out about their service to make sure service members and beneficiaries have all the tools they need to combat persistent risks associated with tick-borne diseases.
“The more submissions we get, the better our surveillance data is, and the more detailed information we can provide about the risks at a specific military installation,” said Nadolny.
The MilTICK program now makes testing that tick even easier. To access the program, any DOD beneficiary with a tick bite simply needs to download the instructions, the form, and the USDA permit (all available online). Beneficiaries then need to place their tick in a resealable bag and mail it in an envelope with the other required documents. All the information they need to participate and mailing can be found on APHC’s MilTICK page.
“It’s important not to damage your tick before you send it, so that the MilTICK staff can identify your specimen and make sure it is tested appropriately,” said Nadolny. “MilTICK staff will be in touch as quickly as possible with a preliminary result if a tick is positive, but final results of all testing are generally reported within two weeks.”
The Army Public Health Center enhances Army readiness by identifying and assessing current and emerging health threats, developing and communicating public health solutions, and assuring the quality and effectiveness of the Army’s Public Health Enterprise.